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I NTER VIEW


Dr Gustav von Schulthess on Paradigm shift in medical visualization enabled by PET/CT scan


1. in a nutshell, what is Pet/Ct used for? What are its applications and how is this different from Pet/ Ct+mr? PET/CT is currently THE established integrated clinical molecular imaging modality used worldwide for tumor staging and therapy monitoring in a vast majority of malig- nant tumors. Additional indications for PET/CT are in imag- ing of inflammation. The current use of PET/CT in the clini- cal evaluation of brain disease and heart disease is limited. In the brain, image fusion of PET and MR data obtained on separate systems is a standard accepted procedure and in the heart, fusion of PET and CT data is of limited value. If required in the latter disease entities, integration can also be achieved by software fusion. PET/CT-MR is an experimental system designed to


evaluate whether there are future applications of PET/MR which are more accurate (higher sensitivity and specifici- ty) than PET/CT. Currently, there is no clinical data which would suggest that PET/MR can replace PET/CT in clinical applications. Rather, the current workup in cancer imaging involves PET/CT followed or preceded in some settings by a dedicated MR scan focused on a specific question such as better identification and characterization of liver lesions.


2. What are the potential implications of this on current and future clinical care developments? Potential implications are that running larger patient series using PET/CT-MR will define whether and where replace- ment of PET/CT by PET/MR is beneficial. If indeed it is possi- ble to demonstrate that in certain disease entities PET/MR is more accurate (specific and sensitive) than PET/CT, PET/ MR will replace PET/CT in such applications.


3. are there potential drawbacks or side effects to a Pet/Ct scan and a Pet/Ct+mr scan? The main drawback of a PET/CT scan is its radiation dose. Replacing the CT portion by MR will eliminate the


44 INSIGHT ON


HOSPITAL & HEALTHCARE MANAGEMENT Vol. 1 Issue 2 August 2011


Dr Gustav von Schulthess is the co-director of the International Diagnostic Course Davos organization, which organizes organ- based imaging courses in Davos, Switzerland, Greece and Hong Kong. Between 2005 and 2007, von Schulthess was Chief Medical Officer of UHZ and since January 2010 Chairman of the entire imaging department. He is a consultant to Icon Medical, GE and the government of Luxemburg.


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